Aberrantly expressed Bruton’s tyrosine kinase preferentially drives metastatic and stem cell-like phenotypes in neuroblastoma cells



Neuroblastoma, a common childhood tumor, remains one of the most elusive diseases to treat. To date, high-risk neuroblastoma is associated with low survival rates. To address this, novel and more effective therapeutic strategies must continue to be explored.


We employed a bioinformatics approach corroborated with in vitro and in vivo data. Samples from neuroblastoma patients were retrieved and immuno-stained for Bruton’s tyrosine kinase (BTK). To evaluate its effect on cellular functions, BTK expression in SK-N-BE(2) and SH-SY5Y neuroblastoma cells was downregulated using gene silencing or inhibition with ibrutinib or acalabrutinib. Xenograft mouse models were used to investigate the in vivo role of BTK in neuroblastoma tumorigenesis.


We found that BTK was highly expressed in primary neuroblastoma samples, preferentially in MYCN-amplified neuroblastoma cases, and was associated with a poor prognosis. Immunohistochemical staining of tissues from our neuroblastoma cohort revealed a strong BTK immunoreactivity. We also found that neuroblastoma SK-N-BE(2) and SH-SY5Y cells were sensitive to treatment with ibrutinib and acalabrutinib. Pharmacologic or molecular inhibition of BTK elicited a reduction in the migratory and invasive abilities of neuroblastoma cells, and ibrutinib considerably attenuated the neurosphere-forming ability of neuroblastoma cells. Both inhibitors showed synergism with cisplatin. In vivo assays showed that acalabrutinib effectively inhibited neuroblastoma tumorigenesis.


From our data we conclude that BTK is a therapeutically targetable driver of neuroblastoma.

Graphical abstract

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Data availability

The datasets used and analyzed in the study are available from the corresponding author upon reasonable requests.


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The authors thank the research assistants at the Core Facility Center, Department of Medical Research, Taipei Medical University - Shuang Ho Hospital, especially Mr. Iat-Hang Fong and Mr. Sam Huang, for their technical assistance with cell-based assays. The authors also thank Dr. Alexander TH Wu and Mr. Oliver Huang for their interest and constructive advice in the animal experimental designs and their skillful technical support of this project. This manuscript was edited by Wallace Academic Editing.


This work was supported by the National Science Council of Taiwan: Tsu-Yi Chao (MOST105-2314-B038-080 and MOST 108-2314-B-038-051-MY3). It was also supported by a grant from National Taiwan University Hospital: Wen-Ming Hsu (107-S3825).

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NWP: project conception, experimental design, generation and collation of data, data analysis and interpretation, manuscript writing. YLL, OAB: project conception, experimental design, collation and/or assembly of data, data analysis and interpretation, manuscript writing and revision. YLL, MH, WMH: data assembly and analysis. SMH and Sutaryo: assistance with data generation. MH, CTY, TYC: experimental design, data analysis and interpretation, provision of useful research insight and essential reagents, and administrative oversight. All authors read and approved the final submitted version.

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Correspondence to Tsu-Yi Chao or Chi-Tai Yeh.

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Clinical samples were collected from the National Taiwan University Hospital (Taipei City, Taiwan). All enrolled patients gave written informed consent for their tissues to be used for scientific research. The study was approved by the Joint Institutional Review Board of National Taiwan University Hospital (201705121RIND), consistent with the recommendations of the Declaration of Helsinki for biomedical research.

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• Bruton’s Tyrosine Kinase (BTK) is highly expressed in neuroblastoma

• High BTK expressing tumors is associated with poorer prognosis

• BTK inhibitor, Ibrutinib, reduced neuroblastoma cells migration and invasion ability

• Ibrutinib also lowered Neuro-sphere formation potential of neuroblastoma cells

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Pikatan, N.W., Liu, YL., Bamodu, O.A. et al. Aberrantly expressed Bruton’s tyrosine kinase preferentially drives metastatic and stem cell-like phenotypes in neuroblastoma cells. Cell Oncol. 43, 1067–1084 (2020). https://doi.org/10.1007/s13402-020-00541-5

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  • Pediatric brain tumor
  • Neuroblastoma
  • Bruton’s tyrosine kinase
  • Ibrutinib
  • Acalabrutinib
  • Cancer stem cells
  • Metastasis